Impact of the Number of Negative Nodes on Disease-Free Survival in Colorectal Cancer Patients

Wong, Jan H.; Bowles, B. Jason; Bueno, Racquel S.; Shimizu, David

doi:10.1007/s10350-004-6423-6

Cited by 81 publications

(41 citation statements)

References 26 publications

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“…33 The optimal number of lymph nodes that should be assessed for accurate nodal staging appears to be 7-14. 34 However, the number of lymph nodes retrieved from the resection specimen differs widely between centers for colorectal surgery, reflecting a surgical variability in the extent of the operation.…”

Section: Pathological Analysismentioning

confidence: 99%

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

et al. 2007

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Background: The primary role of sentinel lymph node (SLN) mapping in colon cancer is to increase the accuracy of nodal staging by identifying those lymph nodes with the greatest potential for harbouring metastatic disease. Ultrastaging techniques aim to identify the otherwise undetected metastases. Until now, no consensus exists as to the most optimal procedure in patients with colon cancer.Methods: A systematic literature search on the value of different SLN mapping techniques in patients with colon cancer was performed using the electronic search engine PubMed. Prospective studies published before 1 December 2005 were included and further articles were selected by cross-referencing. The results of different techniques using either blue dye or radiocolloid, were investigated.Results: The literature search yielded 17 relevant articles. SLN mapping using blue dye was described in 15 studies. Two studies reported the results of SLN mapping using a combination of blue dye and radiocolloid. The reported results on identification rate varied between 71 and 100%. Accuracy rates were between 78 and 100%, sensitivity rates between 25 and 100% and true upstaging rates between 0 and 26%. The results were not affected by the addition of radiocolloid to blue dye.Conclusions: Sentinel lymph node mapping in patients with colon cancer remains an experimental procedure with varying results. Further evaluation may lead to a standardized technique that offers the potential for significant upstaging of stage II patients. This may have important implications as to tailor adjuvant chemotherapeutic regimens in these patients.

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Section: Pathological Analysismentioning

confidence: 99%

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

et al. 2007

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“…This effect has been demonstrated in patients with stage II colon cancer and may in part explain why, as TLNs assessed increased, the differences in survival among sites decreased. 18,19 In colorectal cancer, the factors that have been correlated with lymph node yields are age, obesity, and tumor HR indicates hazard ratio; CI, confidence interval; TLN, total number of lymph nodes assessed; PLN, total number of positive lymph nodes; LNR, lymph node ratio; NOS, not otherwise specified; Well-mod, well to moderately differentiated; Poor, poorly differentiated; NOS, not otherwise specified.…”

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confidence: 99%

Prognostic value of lymph node evaluation in small bowel adenocarcinoma

Overman

Wolff

et al. 2010

Cancer

104

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BACKGROUND:The presence of distant metastases and the completeness of resection are important prognostic factors in patients with small bowel adenocarcinoma (SBA); however, the influence of lymph node metastasis on patient outcome has not been well characterized. The objective of the current study was to evaluate the impact of the number of positive and negative lymph nodes on survival after curative resection. METHODS: Patients who had SBA diagnosed between 1988 and 2005 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry. Cox proportional hazards regression analyses were performed after adjusting for age, sex, race, tumor stage, tumor grade, and primary site. Five-year disease-specific survival (DSS) was determined, all patients were categorized according to the total lymph nodes (TLNs) assessed, and patients with stage III disease also were categorized according to the number of positive lymph nodes (PLNs) and the PLN-to-TLN ratio (the lymph node ratio [LNR]). RESULTS: In total, 1991 patients (n ¼ 1216 with stage I/II SBA and n ¼ 775 with stage III SBA) were analyzed. Survival depended on the TLNs assessed. The 5-year DSS rate for patients with stage II disease was associated with the TLNs assessed (44%, 69%, and 83% for 0 TLNs, 1-7 TLNs, and >7 TLNs, respectively). The 5-year DSS for patients with stage III disease was associated with the number of PLNs (58% and 37% for <3 PLNs and 3 PLNs, respectively). Among patients with stage III disease, the LNR was even more predictive of survival than stratification by the number of PLNs. CONCLUSIONS: Survival after surgical resection for stage I, II, and III SBA was associated with the TLNs assessed. Stratifying patients with stage III disease into those with <3 PLNs and 3 PLNs significantly improved prognostication. Cancer 2010;116:5374-82.

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“…The more the number of sampled lymph nodes, the better the prognosis [15] , and the number of sampled nodes is associated with more accurate staging and DFS prediction [16] . In our study, sampling 12 or fewer lymph nodes were associated with the recurrence of stage II rectal cancer, consistent with previous reports.…”

Section: Discussionmentioning

confidence: 99%

Tumor Diameter Is an Easy and Useful Predictor of Recurrence in Stage II Colorectal Cancer

et al. 2015

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Background/Aims: Adjuvant chemotherapy for stage II colorectal cancer (CRC) can generally be administered to high-risk subgroups. To better identify these patients, we aimed at assessing factors that affect recurrence. Methods: In our hospital, 432 colon and 96 rectal stage II cancer patients who underwent surgical resection between 2001 and 2011 were divided into recurrence and non-recurrence groups. Age, sex, lymphatic vessel invasion, venous invasion, tumor diameter, tumor depth, histological type, preoperative carcinoembryonic antigen level, number of sampled nodes, adjuvant chemotherapy, morphology, surgical approach, anastomotic leakage, preoperative bowel obstruction, and preoperative perforation were retrospectively compared between the groups. Results: For colon cancer, multivariate analysis revealed a significant association between tumor diameter ≥40 mm and recurrence (p = 0.039). For rectal cancer, multivariate analysis revealed that tumor diameter ≥50 mm (p = 0.001) and ≤12 sampled nodes (p = 0.021) were associated with recurrence. Tumor diameter in rectal cancer was associated with worse disease-free survival (p = 0.026). Conclusion: Tumor diameter is a significant predictor of recurrence in stage II CRC. This is an important finding because tumor diameter is easy to evaluate clinically and might help to identify candidates for adjuvant chemotherapy.

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Impact of the Number of Negative Nodes on Disease-Free Survival in Colorectal Cancer Patients

Abstract: The extent of the pathologic assessment of the nodal status of colorectal cancer patients as determined by the number of nodes examined affects disease-free survival. The need for quality control for uniform pathologic assessments is critical.

Cited by 81 publications

References 26 publications

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

Sentinel Lymph Node Mapping in Colon Cancer: Current Status

Prognostic value of lymph node evaluation in small bowel adenocarcinoma

Tumor Diameter Is an Easy and Useful Predictor of Recurrence in Stage II Colorectal Cancer

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